EMERGENCY PERIPARTUM HYSTERECTOMY: INDICATIONS AND OBSTETRIC OUTCOME (A 5-YEAR REVIEW)

Authors

  • Dr. Raghunath Bhattacharyya MS (G&O), Assistant Professor, College of Medicine & Sagore Dutta Hospital, Kolkata
  • Dr. Kasturi Mukherjee Demonstrator,R. G. Kar Medical College, Kolkata

Keywords:

Peripartum Hysterectomy, emergency Hysterectomy, obstetric Hysterectomy

Abstract

Objective: To review cases of emergency peripartum hysterectomy regarding their incidence, risk factors, indications and complications and their results were carefully analysed.

Materials and method: A retrospective study of cases of emergency peripartum hysterectomy which were performed in the period between January 2011 and December 2015 at R. G. Kar  Medical College & Hospital in West Bengal was done. Clinical data were extracted and closely interpreted.

Results:  In the study period there were 84,093 deliveries and 81 cases of peripartum hysterectomies. The overall incidence was 0.096%. Caesarean hysterectomy was performed in 51 cases (0.373%) and postpartum hysterectomy was performed in 30 cases (0.042%). Total hysterectomy was performed in 23cases (28.4%) and subtotal hysterectomy was performed in 58 cases (71.6%). The main indications for hysterectomy were uncontrolled postpartum haemorrhage (43.2%), ruptured uterus (32%) and morbidly adherent placenta (24.7%). There were 9 maternal deaths and 32 cases of stillbirths.

Conclusion: Peripartum hysterectomy is a major, life saving operation. Although PPH is the main indication, it is significantly associated with post caesarean cases. Obstetricians should identify patients at risk and anticipate the procedure and complications, as early intervention and proper management facilitate optimal outcome.

References

I. Praneshwari Devi RK, Singh NN, Singh D. Emergency obstetric hysterectomy. J Obstet Gynecol India 2004;54:343-5.

II. Kant A, Wadhwani K. Emergency obstetric hysterectomy. J Obstet Gynecol India 2005;55:132-4.

III. Kore S, Potwar S,Tamboli J et al. Obstetric hysterectomy analysis of 34 cases. J Obstet Gynecol India 2001; 51:94- 6.

IV. Pati S, Saumandal BK, Choudhari S, Recent scenario in obstetric hysterectomy: an analytical montage of 73 cases over a period of 5 years J Obstet Gynecol India 1998;48:51-4.

V. Sahasrabhojanee Mrinalini, Jindal Manjusha, Kamat Anjali, Obstetric hysterectomy: a life saving emergency. J Obstet Gynecol India 2008; 58: 138-41

VI. Selc¸uk O ¨ zden Æ G. Yildirim Æ T. Basaran Æ B. Gurbuz V. Dayicioglu. Analysis of 59 cases of emergent peripartum hysterectomies during a 13-year period. Arch Gynecol Obstet 2005; 271: 363–7

VII. Wai Yoong Æ Nadine Massiah Æ Ade Oluwu. Obstetric hysterectomy: changing trends over 20 years in a multiethnic high risk population. Arch Gynecol Obstet 2006; 274: 37–40

VIII. Flood KM, Said S, Geary M, et al. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol 2009; 200:632.e1- e6.

IX. Sarah Glaze, Pauline Ekwalanga, Gregory Roberts, Ian Lange, Colin Birch, Albert Rosengarten, John Jarrell, and Sue Ross. Peripartum Hysterectomy 1999 to 2006. Obstet Gynecol 2008;111:732–8

X. Pawar PA, Shrotri A. Role of emergency hysterectomy in obstetris. J Obstet Gynecol India 1998; 48:46-7.

Additional Files

Published

15-05-2016

How to Cite

Dr. Raghunath Bhattacharyya, & Dr. Kasturi Mukherjee. (2016). EMERGENCY PERIPARTUM HYSTERECTOMY: INDICATIONS AND OBSTETRIC OUTCOME (A 5-YEAR REVIEW). International Education and Research Journal (IERJ), 2(5). Retrieved from http://ierj.in/journal/index.php/ierj/article/view/263